Hospital at Home: How Home-Based Care Supports Recovery and Improves Outcomes

For all the advanced technology and innovative procedures of hospital medicine, a return to the “home visit” is showing promise for improving patient satisfaction and outcomes.

Since 2020, the Centers for Medicare & Medicaid Services (CMS) have authorized nearly 400 facilities in 39 states to offer acute “hospital care at home” programs around the U.S.

“We are moving in the direction of the ‘hospital at home’ concept because it is way less complicated and delivers the same high-quality outcomes at a small fraction of the cost,” said Dr. Jeremy Wigginton, Chief Medical Officer at Capital Blue Cross. “It’s evolving. Not every system has a program and eligibility varies from program to program. But patients need to stay informed and ask their care provider if it is an option for them.”

A recent study found that patients in hospital at home programs have lower mortality rates, lower post-discharge spending, and higher satisfaction than patients receiving in-patient care in hospitals.

While the hospital at home model was originally created in the 1990s, its recent growth came during the COVID pandemic when CMS waived normal rules that required around-the-clock care to be performed in hospitals. In 2025, Congress is expected to revisit an option to keep that waiver in place.

Hospital at Home: How Home-Based Care Supports Recovery and Improves Outcomes

The Benefits of At-Home Care

Whether it’s to treat chronic conditions or recover after a complex surgery, the benefits of at-home care include the following:

  • Faster recovery: Regular monitoring and early intervention when complications arise can reduce hospital readmissions.
  • More convenient: Home care reduces the need for travel to medical facilities, saving patients from logistical headaches during their recovery time.
  • Promotes independence: The familiar surroundings of home can empower patients to participate in the decision-making processes, creating a collaborative and personalized approach to care.
  • Encourages family involvement: When family members play a hands-on role, it often ensures that the patient receives support beyond the clinical aspects of care.

Who Qualifies for Hospital at Home Programs?

If you quality for a hospital at home care option, it’s important to check to see if your health plan covers services. Capital Blue Cross’ standard home healthcare benefits provide medically necessary skilled care services to homebound patients, which may include treatment for the following conditions (as outlined in its member benefit booklet):

  • Acute illness.
  • Acute exacerbation (sudden worsening of a disease or its symptoms) of a chronic illness.
  • Rehabilitative services to help a person regain, maintain, or improve skills or functioning for daily living that have been acquired but then lost or impaired due to illness, injury, or disabling condition.
    • Services like: Cardiac therapy, respiratory/pulmonary therapy, physical therapy, occupational therapy, and speech therapy.
  • Medical and surgical supplies may be given to an individual by a physician, home health agency, or healthcare worker to treat an illness or medical condition (e.g. wound care).

Hospital At Home vs. Traditional Home Healthcare

While both home healthcare and hospital at home services provide treatment outside of a hospital, it’s important to know these key differences.

Feature

Hospital at Home

Traditional Home Healthcare

Intensity of Care

Acute, short term (usually five days).

Subacute, longer term.
Frequency of Care

Daily visits from doctors, nurses, or EMTs with 24/7 virtual monitoring.

Intermittent visits from healthcare professionals.

Services Provided

More intensive care (e.g., IV therapies, lab tests, mobile ultrasounds, and more).

General nursing care, rehabilitation, and therapy services.

According to CMS data, the most common conditions treated by hospital at home programs include respiratory (36%), circulatory (16%), renal (16%), and infectious diseases (12%).

How to Check if Your Insurance Covers Home Healthcare

Coverage for home healthcare services varies by health plan. Capital Blue Cross members can check benefits and eligibility by reviewing their benefits booklet, or by contacting Member Services at the number on the back of their ID cards.